The ICGD Student Travel Award

Interdisciplinary Center for Global Diversity Student Travel Award

Applicant Name Applicant Name First Last
College
Major
Phone Phone - ### - ### ####
Email
I. Activity: Presenting original research/creative activity at a conference
Name of Conference
Location
From Date From Date / MM / DD YYYY
To Date To Date / MM / DD YYYY
Title of Presentation
II. Expenses: A cost estimate of the proposed activity.
Transportation: $ Dollars . Cents
Lodging (room rate x days): $ Dollars . Cents
Conference Registration $ Dollars . Cents
Miscellaneous (must be documented): $ Dollars . Cents
Total estimated or actual expenses: $ Dollars . Cents
Contributions from a grant or source other than your personal funds: $ Dollars . Cents
Amount requested: $ Dollars . Cents
III. Abstract of Your Paper/Creative Work (Up to 200 Words)